又有寒泄者。大腹满而泄。又有 溏者。是寒泄也。 溏者。大便如水。中有少结粪者是也。如此者。当
用天麻附子干姜之类是也。
又法曰。泄有虚实寒热。虚则无力更衣。不便已泄出。谓不能禁固也。实则数至圊而不能便。俗云虚坐弩
责是也。里急后重。皆根据前法进退大承气汤主之。一说素问云。春伤于风。夏生飧泄。又云久风为飧泄者。乃
水谷不化而完出尔。非水入胃而成此证。非前水恣也。此一证。不饮水而谷完出。名曰飧泄。治法于后。先以
宣风散导之。出钱氏方中四味者是也。后服苍术防风汤。
苍术防风汤
苍术（去皮四两） 麻黄（去根节四两） 防风（去芦头五钱）
上为粗末。每服一两。生姜七片。水二盏。煎至一盏。去滓温服。泄止后服椒术丸。
椒术丸
苍术（二两） 蜀椒（一两去目炒）
上为极细末。醋糊为丸。如桐子大。每服二十丸。或三十丸。食前温水下。一法。恶痢久不愈者。加桂。
如小儿病。丸如黍
米大。
治泻痢脓血。乃至脱肛。地榆芍药汤
苍术（一两） 地榆（二两） 卷柏（三两） 芍药（三两）
上 咀。每服一两。水一大盏半。煎至一半温服清。病退药止。
五泄伤寒。乃分三节。初说暴，次说中。后说久泄。
此说在难经二十二难。是三节内包十五法。初以暴药。中以的对证药。后疾得中也。末治久泄法。仲景论
厥阴经治法是也。
治久泄法。先进缩煎小续命汤。是发其汗。使邪气不能从外侵于内。然后治其痢。秋冬间下痢风。吐论中
加减浓朴丸大效。
凡脏腑之秘。不可一例治疗。有虚秘。有实秘。胃实而秘者。能饮食小便赤。当以麻仁丸七宣丸之类主之。
胃虚而秘者。不能饮食。小便清利。浓朴汤主之。
浓朴（姜制五两） 白术（五两） 半夏（二两） 枳实（一两炒） 陈皮（去白二两） 甘草（三两炙）
上为粗末。每服三五钱。水一盏半。生姜五片。枣三枚。煎至一盏。去滓温服空心。实秘者物也。虚秘者
气也。
平胃丸 治病久虚弱。厌厌不能食。而脏腑或秘或溏。此胃气虚弱也。常服和中消痰去湿。及浓肠胃。
进饮食。
浓朴（一两） 白术（一两二钱） 陈皮（八钱去白） 木香（一钱） 生半夏（汤洗一两） 槟榔（二钱半）
枳实（五分） 甘草（三钱炙）
上为细末。姜汁浸蒸饼为丸。如桐子大。每服三五十丸。生姜汤或温水送下。
又有寒性泄泻者，表现为腹部胀满且腹泻。还有大便稀溏的，属于寒性泄泻。所谓“溏”，是指大便像水一样，其中夹杂少量成形的粪便。遇到这种情况，应当使用天麻、附子、干姜之类的药物进行治疗。
另一种说法是：泄泻有虚证和实证、寒证和热证的区别。虚证表现为排便无力，即使已经排出也感觉未排尽，称为不能固摄；实证表现为频繁去厕所却排不出大便，俗称“虚坐努责”（想排便但无物可出，伴有肛门坠胀感）。出现里急后重（腹痛窘迫，时时欲便，肛门重坠，便出不爽）等症状，都依据前面的方法，对大承气汤进行加减化裁来主治。还有一种说法引用《素问》的话：“春季感受风邪，夏季发生飧泄（完谷不化的泄泻）。”又说“久风为飧泄”，意思是水谷不消化而原样排出，并非因为喝水多导致胃中积水而成此证，也不是前水泛滥所致。这一类证候，患者不饮水而食物原样排出，名叫飧泄，治疗方法在后面：先用宣风散引导排泄，宣风散出自钱乙方书中的四味药组成；随后服用苍术防风汤。
苍术防风汤
苍术（去皮四两） 麻黄（去根节四两） 防风（去芦头五钱）
以上药材捣成粗末，每次服用一两，加生姜七片，水两盏，煎煮至一盏，滤去药渣，温服。泄泻停止后，再服用椒术丸。
椒术丸
苍术（二两） 蜀椒（一两，去目，炒制）
以上药材研成极细末，用醋糊制作成丸剂，大小如梧桐子。每次服用二十丸或三十丸，饭前用温水送下。另一种方法：对于恶痢（严重痢疾）日久不愈者，加入桂枝。如果是小儿患病，丸剂大小如黍米。
治疗泻痢带脓血，甚至脱肛的地榆芍药汤
苍术（一两） 地榆（二两） 卷柏（三两） 芍药（三两）
以上药材切碎，每次服用一两，加水一大盏半，煎煮至一半量，温服清汁。病情减退即停药。
五泄伤寒，分为三个阶段。首先论述暴发性泄泻，其次论述中期泄泻，最后论述久泄。
这部分内容在《难经·二十二难》中有记载，这三个阶段包含了十五种治法。初期用暴发性泄泻的药物，中期用对症的药物，后期疾病得到控制。最后是治疗久泄的方法，这是张仲景论述厥阴经治法的内容。
治疗久泄的方法：先进服缩煎小续命汤，通过发汗使邪气不能从体表侵入体内，然后再治疗痢疾。秋冬季节患痢疾兼受风邪，在呕吐论中提到的加减浓朴丸效果显著。
凡是脏腑的便秘，不能一概而论地治疗。有虚秘，有实秘。胃实导致的便秘，患者能进食，小便颜色赤红，应当以麻仁丸、七宣丸之类的药物为主治。胃虚导致的便秘，患者不能进食，小便清澈通利，以浓朴汤为主治。
浓朴汤
浓朴（姜制五两） 白术（五两） 半夏（二两） 枳实（一两，炒） 陈皮（去白二两） 甘草（三两，炙）
以上药材捣成粗末，每次服用三到五钱，加水一盏半，生姜五片，大枣三枚，煎煮至一盏，滤去药渣，空腹时温服。实秘是由有形之邪阻滞所致，虚秘是由气虚推动无力所致。
平胃丸
治疗病久体虚，精神萎靡不想吃东西，而且脏腑时而便秘时而稀溏的情况，这是胃气虚弱造成的。经常服用可以调和脾胃，消除痰湿，燥湿健脾，增进饮食。
浓朴（一两） 白术（一两二钱） 陈皮（八钱，去白） 木香（一钱） 生半夏（汤洗一两） 槟榔（二钱半）
枳实（五分） 甘草（三钱，炙）
以上药材研成细末，用姜汁浸泡蒸饼制成丸剂，大小如梧桐子。每次服用三五十丸，用生姜汤或温水送下。
There is also cold-type diarrhea (cold-type diarrhea), characterized by abdominal fullness and diarrhea. There is also loose stool (loose stool), which belongs to cold-type diarrhea. "Loose stool" refers to stools that are watery, containing a small amount of formed feces. In such cases, one should use herbs such as Gastrodiae Rhizoma (Tianma), Aconiti Lateralis Radix Praeparata (Fuzi), and Zingiberis Rhizoma (Ganjiang).
Another method states: Diarrhea can be classified into deficiency and excess patterns, as well as cold and heat patterns. Deficiency patterns manifest as weakness in defecation; even after excretion, there is a sensation of incomplete evacuation, termed inability to retain (inability to retain). Excess patterns manifest as frequent trips to the toilet without ability to pass stool, commonly known as "straining with empty bowels" (straining with empty bowels). Symptoms such as tenesmus (tenesmus) follow the previous methods, primarily treating with modified Dachengqi Tang (Major Order the Qi Decoction). Another interpretation cites the *Suwen*: "Wind injured in spring leads to undigested diarrhea (undigested diarrhea) in summer." It also says, "Long-standing wind causes undigested diarrhea," meaning food and water are not digested and are expelled intact. This is not caused by excessive water intake forming this syndrome, nor is it due to flooding of prior fluids. This syndrome involves the expulsion of intact food without drinking water, named undigested diarrhea. The treatment method follows: first use Xuanfeng San (Dispel Wind Powder) to guide excretion, which consists of four ingredients from Qian Yi's formulas. Subsequently, take Cangzhu Fangfeng Tang (Atractylodis Rhizoma and Saposhnikoviae Decoction).
Cangzhu Fangfeng Tang (Atractylodis Rhizoma and Sapothnikoviae Decoction)
Cangzhu (Atractylodis Rhizoma, peeled, 4 liang)
Mahuang (Ephedrae Herba, roots and joints removed, 4 liang)
Fangfeng (Saposhnikoviae Radix, awn removed, 5 qian)
Grind these into coarse powder. Take 1 liang per dose, add 7 slices of fresh ginger, and 2 zhan of water. Decoct until 1 zhan remains, remove dregs, and take warm. After diarrhea stops, take Jiaozhu Wan (Zanthoxyli and Atractylodis Pill).
Jiaozhu Wan (Zanthoxyli and Atractylodis Pill)
Cangzhu (Atractylodis Rhizoma, 2 liang)
Shujiao (Zanthoxyli Pericarpium, 1 liang, eyes removed, stir-fried)
Grind these into extremely fine powder. Make pills using vinegar paste, size of Sophora japonica seeds. Take 20 or 30 pills per dose before meals with warm water. Another method: for severe dysentery (severe dysentery) that persists for a long time, add Guizhi (Cinnamon Twig). For pediatric cases, make pills the size of millet grains.
Diyu Shaoyao Tang (Sanguisorbae Radix and Paeoniae Radix Decoction) for treating diarrhea and dysentery with pus and blood, even to the point of rectal prolapse (rectal prolapse).
Cangzhu (Atractylodis Rhizoma, 1 liang)
Diyu (Sanguisorbae Radix, 2 liang)
Juanbai (Selaginellae Herba, 3 liang)
Shaoyao (Paeoniae Radix, 3 liang)
Cut these into pieces. Take 1 liang per dose, add 1.5 zhan of water. Decoct until half remains. Take the clear liquid warm. Stop medication when symptoms recede.
Five types of diarrhea complicated by shanghan (shanghan) are divided into three stages. First, acute onset is discussed; second, intermediate stage; finally, chronic diarrhea (chronic diarrhea).
This discussion is found in Chapter 22 of the *Nanjing*, encompassing fifteen methods within these three stages. Initially, drugs for acute onset are used; in the middle, specific symptomatic drugs are used; later, the disease is controlled. The final method treats chronic diarrhea, which corresponds to Zhang Zhongjing's (Zhang Zhongjing) treatment methods for the Jueyin meridian (Jueyin meridian).
Treatment method for chronic diarrhea: First administer Suojian Xiao Suming Tang (Concentrated Decoction of Minor Suming Decoction) to induce sweating, preventing pathogenic factors from invading internally from the exterior. Then treat the dysentery. In autumn and winter, for dysentery complicated by wind, Jiajian Houpo Wan (Modified Magnoliae Officinalis Bark Pill) mentioned in the vomiting treatise is highly effective.
Constipation of the zang-fu organs cannot be treated uniformly. There is deficiency constipation (deficiency constipation) and excess constipation (excess constipation). Constipation due to stomach excess allows for normal appetite and dark urine; treat primarily with Mahuan Wan (Hemp Seed Pill) or Qixuan Wan (Seven Invigorating Pills). Constipation due to stomach deficiency prevents eating and results in clear, profuse urine; treat primarily with Houpo Tang (Magnoliae Officinalis Bark Decoction).
Houpo Tang (Magnoliae Officinalis Bark Decoction)
Houpo (Magnoliae Officinalis Cortex, ginger-processed, 5 liang)
Baizhu (Atractylodis Macrocephalae Rhizoma, 5 liang)
Banxia (Pinelliae Tuber, 2 liang)
Zhishi (Immature Bitter Orange Fruit, stir-fried, 1 liang)
Chenpi (Citri Reticulatae Pericarpium, white pith removed, 2 liang)
Gancao (Licorice Root, honey-fried, 3 liang)
Grind into coarse powder. Take 3-5 qian per dose, add 1.5 zhan of water, 5 slices of fresh ginger, and 3 jujubes. Decoct until 1 zhan remains, remove dregs, and take warm on an empty stomach. Excess constipation is caused by tangible pathogens; deficiency constipation is caused by qi deficiency.
Pingwei Wan (Peace the Stomach Pill)
Treats prolonged illness leading to weakness, listlessness, loss of appetite, and alternating constipation and loose stools in the zang-fu organs, which is due to weak stomach qi (weak stomach qi). Regular consumption harmonizes the middle, eliminates phlegm and dampness, strengthens the intestines and stomach, and promotes appetite.
Houpo (Magnoliae Officinalis Cortex, 1 liang)
Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang 2 qian)
Chenpi (Citri Reticulatae Pericarpium, 8 qian, white pith removed)
Muxiang (Vladimiriae Root, 1 qian)
Sheng Banxia (Pinelliae Tuber, raw, washed in boiling water, 1 liang)
Binglang (Areca Seed, 2.5 qian)
Zhishi (Immature Bitter Orange Fruit, 5 fen)
Gancao (Licorice Root, 3 qian, honey-fried)
Grind into fine powder. Soak steamed leaven cakes in ginger juice to make pills, size of Sophora japonica seeds. Take 30-50 pills per dose, delivered with ginger soup or warm water.